Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings.

Abstract

Background: Intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) is one of the rarer clinical entities in the pediatric population, carrying a high degree of morbidity and mortality. The focus of this review is on assessing pathophysiological changes of organ systems in pediatric patients with risk factors for the occurrence of IAH/ACS based on the evaluation of diagnostic modalities and therapeutic strategies.

Methodology: A comprehensive literature search of indexed databases was performed, aiming to identify, review, and evaluate published articles on IAH/ACS. The search was focused on studies examining pathophysiology, risk factors, diagnostic approaches, and management strategies.

Results: The main risk factors encompass diminished abdominal wall compliance, increased intraluminal and abdominal contents, and capillary leak/fluid resuscitation. Diagnostic tools include clinical and imaging findings, intra-abdominal pressure (IAP) monitoring, and parameters of tissue perfusion. Therapeutic strategies involve non-surgical and surgical management of IAH/ACS in pediatric patients.

Conclusion: Timely and continuous evaluation of IAP and parameters of tissue perfusion is crucial for the early diagnosis of IAH/ACS and implementing non-surgical procedures, reducing the need for surgical procedures. Future research should focus on the usefulness of advanced non-invasive monitoring technologies and the identification of predictors of increased IAP in the early implementation of personalized therapeutic strategies.